Clinical And Pathology Research Of Rathke Cleft Cysts

ObjectiveTo summarize the clinical manifestation, radiology imagining, endocrine examination, operative method and pathology result of Rathke cleft cysts. To explore the characteristics and recurrence of Rathke cleft cysts.MethodsThe clinical data of 26 patients pathologically diagnosed Rathke cleft cysts were retrospectively reviewed and analyzed,which were hospitalized in the First Affiliated Hospital of Suzhou University from July 2000 to January 2010.They all had been followed up and had complete information. We conducted a study to investigate preoprative clinical,radiograhpic,pathological and surgical features which can distinguish it from other sella turica diseases.Results1. The average age is 40.6士10.1years old,the average course of disease is 25.5士10.6 months,the length of hospitalization is 8.9士5.8days.The typical clinical manifestations of the disease were headache(69.7%), and visual dysfunction(35.6%), amenorrhea (45.4%),decreased libido(69.7%), diabets insipidus(3.0%).2. Computed tomography(CT)showed low density cystic mass in the area of sella turica with barely calcification and no enhancement. Magnetic Resonance Imaging (MRI) showed mostly low or iso signals in T1WI and high signals in T2WI.The cyst fluid has no obvious distinction in contrast,while the cyst wall show irregular enhancement.3. 24 cases were treated by transnasal-sphenoidal microsurgery,while 2 cases through craniotomy.In 5 months to 11 years follow-ups,headache disappeared in all cases to some extent, 94.4% (17/18) patients with pituitary dysfunction improved,and 90%(9/10) with visual deficiency recovered, and only 2 cases recurrence.4.Only 12 cases were correctly diagnosed before operation.10 cases (37.3%) were misdiagnosed as pituitary adenomas,2 cases (7.6%) were misdiagnosed as pituitary apoplexy and 2 cases(7.6%)were misdiagnosed as craniopharyngiomas.ConclusionsIt is difficult to diagnose the disease preoperatively , Transphenoidal operation is the best solution for Rathke cleft cysts with good prognosis. Not repairing the sella bottom can prevent or reduce the Rathke cleft cysts recurrence.